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This is part II to “37 year old male–CC: Chest Pain“. You may wish to review the case. So, while many of our cases are straightforward, this one is not. But hey, our patients don’t read theÂ textbooks! First, let’s review the chief complaint: Our 37 year old male had “chest tightness”, but complained of lethargy […]

This excellent case comes to us from Paramedic Jack Buckle. Thanks Jack! You and your partner are in the middle of a busy shift, when you are dispatched to 37 year old male complaining of chest pain. It's almost 2pm, and a balmy 78 degrees. You arrive to a well kept house and find your […]

"For heaven's sake man, treat the patient not the monitor!" Ahh, the angry cries appear every time we post a difficult case with a challenging ECG or treatment decision.. The attitude seems intractable, despite our best efforts. Over a year ago, I wrote "Treat the Patient not the Monitor?", and not much has changed […]

This excellent case comes to us from our friends in the UK. The author wishes to remain anonymous, but we thank him for his contribution. It is about 8am on a gorgeous Wednesday morning, when your Paramedic unit is dispatched to a 49 year old male, "chest pain". You arrive at the bungalow of […]

Summer is in full swing, and we are often asked about the best resources out there to learn more about ECG. We decided to put together a list of "Editors' Picks" for some of our favorite "go-to" educational ECG resources. Of course, this list is not comprehensive, and there are many outstanding books and […]

The original presentation of this case appeared as "What's Wrong with Mr. Wilson?"… You can read the original post here. Much has been written lately about RBBB abnormalities that were missed. Dr. Smith has recently posted two cases here, and here discussing this. First, let's review the 12 lead of a typical RBBB. When learning […]

Sometimes recognizing sinus tachycardia can give us fits. What? Sinus tachycardia? One of the most basic rhythms? The discussion that follows will highlight some of the difficulties sinus tach can present at high rates. The pitfalls of using the generalized term "SVT" will also be discussed. This discussion is not meant to imply that […]

It is a sunny January afternoon at the ER when you are called to see a 57 year old male complaining of feeling "really sick". You find your patient lying in the bed in room 3. He looks pale and short of breath. You introduce yourself and ask him why he has come in […]

Today we continue our discussion about the myths and facts of hyperkalemia with Dr. Brooks Walsh, author of the Mill Hill Ave Command blog. We also feature contributions from Dr. Stephen Smith, of Dr. Smith's ECG Blog. If you would like to refresh your memory on Part I visit here. […]

Happy New Year everybody! We start 2013 with a continuation of our discussion about the field treatment of hyperkalemia. It might be helpful to review the first part of the discussion," HyperK and Shades of Grey" here. We are fortunate to have as a guest contributor Dr. Brooks Walsh of the Mill Hill Ave Command blog. […]

Ken Grauer58 Year Old Male, Workout Worry@ Eli — I don’t see AFlutter. That is, I see no indication of regular atrial activity at a rate consistent with AFlutter. Instead, the rhythm is irregularly irregular without P waves = AFib at a controlled ventricular response. In my opinion, one doesn’t need Sgarbossa criteria here to activate the cath lab. So, yes the…
2018-09-13 02:09:24

Vince DiGiulioIs epinephrine harmful in cardiogenic shock?Sorry about that; I copied the quote from the article and my browser automatically changed the "μ" to an "m". Thanks for noticing, and thanks for pointing it out in the most passive-aggressive manner possible.
2018-09-12 16:45:26

Ken Grauer, MDElectrocardiographically Silent High Lateral STEMI EquivalentHi Tom. This is a great case — so NICE that you posted it for others to learned from. But as I commented several times when you sent this case around to our group — the T waves in V2,V3 are disproportionately peaked and transition occurs early (between V1-to-V2) — so the chest leads are NOT…
2018-08-14 08:38:03

Eli58 Year Old Male, Workout WorryAnybody else see the possibility of a LBBB or A-Flutter? I'm not sure if this will make any difference with the treatments but im just trying to interpret it first because if there is a LBBB then it does not meat Sgarbossa criteria and if it is A-Flutter that could explain the hyper acute T's…
2018-07-20 21:29:21